Robotic microsurgery training

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2014-04-04

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Robotic microsurgery is a newly emerging field, which offers several potential advantages to the operating surgeon, including the ability to perform challenging procedures in previously inaccessible locations. As with any new technique, robotic microsurgery requires the acquisition of a novel skillset with a need to overcome the associated learning curve. A review of the available literature suggests that compared to traditional techniques, initial experience with robotic-assisted microsurgery is associated with greater operative times and equivalent surgical outcomes. Although prior robotic experience may help to negate the initial learning curve with robotic microsurgery, existing microsurgical skills appear to be less relevant early on. Longer term, prospective, multi-institutional studies are required to determine if robotic assistance results in earlier technique mastery or improved outcomes as compared to traditional microsurgical approaches. Several modalities are currently available to assist surgeons in improving robotic microsurgical skills including didactics, laboratory simulation with synthetic, in vitro, or in vivo models, dry-dock robotic time, and simulators. Despite clear variability in fidelity of training modalities, performance measures correlate highly and are predictive of intraoperative performance. Given the increasing focus on outcome-based care, initial and subsequent recertification of robotic proficiency will likely be increasingly required.